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Free NREMT EMT practice questions

Tap an answer to see if you are right, and why. 20 questions across 3 topics, mostly Patient assessment (10).

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Passing score: 75% (target)
Format: Computerized adaptive test
Bank: 300 Qs (20 free)
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Questions last updated October 15, 2026 · Questions written from the NREMT EMT Candidate Handbook and the National EMS Education Standards; not official NREMT items.

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  1. Patient assessment1 of 20

    You arrive on scene to find a 58-year-old man clutching his chest and diaphoretic. He is alert but anxious. What is your FIRST priority during the primary assessment?

    The answer

    Answer: B. The primary assessment always begins with evaluating the ABCs (airway, breathing, circulation) to identify and manage life threats. While vital signs, aspirin, and cardiac monitoring are important, they come after the initial assessment of ABCs. Jumping to treatment before completing the primary assessment is a critical error on the NREMT exam.

    Source: NREMT EMT Test Plan - Primary Assessment Domain

  2. Patient assessment2 of 20

    During your primary assessment of an unresponsive trauma patient, you note the patient is breathing inadequately. What should you do FIRST?

    The answer

    Answer: D. Inadequate breathing is an immediate life threat. The first action is to provide positive pressure ventilations with a bag-valve-mask (BVM) to ensure oxygenation. While an OPA may be inserted, ensuring adequate ventilations takes priority. Cervical collars and glucose checks are secondary interventions.

    Source: NREMT EMT Skill Sheet - Airway Management / BVM Ventilation

  3. Patient assessment3 of 20

    A 72-year-old woman presents with slurred speech and left-sided weakness that began 45 minutes ago. Her blood glucose is 110 mg/dL. What is your MOST appropriate action?

    The answer

    Answer: C. This patient's presentation of slurred speech, unilateral weakness, and normal glucose is highly suspicious for a stroke. Stroke patients require rapid transport to a stroke center where CT imaging and potential thrombolytic therapy within a 4.5-hour window can be initiated. Delaying transport for a detailed on-scene assessment wastes critical time.

    Source: NREMT EMT Test Plan - Patient Treatment and Transport / Stroke Assessment

  4. Patient assessment4 of 20

    You are assessing a patient's pulse and note it is weak, thready, and rapid at 120 bpm. The patient's skin is cool and diaphoretic. These findings are MOST indicative of:

    The answer

    Answer: A. A weak, thready, rapid pulse combined with cool, diaphoretic skin are classic signs of hypovolemic shock, typically caused by blood or fluid loss. Anaphylaxis would also present with wheezing or urticaria. Anxiety typically causes a strong bounding pulse. Heat exhaustion usually presents with hot, flushed skin.

    Source: NREMT EMT Test Plan - Primary Assessment / Circulation

  5. Patient assessment5 of 20

    During your secondary assessment, you ask a patient with abdominal pain about onset, provocation, quality, region, severity, and timing. This assessment tool is known as:

    The answer

    Answer: D. OPQRST is a pain assessment mnemonic used to characterize a patient chief complaint: Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, and Time. SAMPLE gathers Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, and Events leading up. AVPU assesses level of consciousness. DCAP-BTLS is a trauma physical exam framework used for head-to-toe assessment.

    Source: NREMT EMT Test Plan - Secondary Assessment / History Taking

  6. Patient assessment6 of 20

    A patient responds to verbal stimuli by opening his eyes and mumbling incoherently. He withdraws from painful stimuli. What is his Glasgow Coma Scale score?

    The answer

    Answer: A. Eye opening to voice = 3, Verbal response of incomprehensible sounds = 2, Motor withdrawal = 4. Total GCS = 3 + 2 + 4 = 9. This indicates moderate brain injury. Patients with GCS of 9 or below may require advanced airway management.

    Source: NREMT EMT Test Plan - Primary Assessment / Disability

  8. Patient assessment7 of 20

    You arrive at a two-car MVC. The driver of the first car is entrapped and unresponsive. The second driver is ambulatory with neck pain. How should you manage this scene?

    The answer

    Answer: C. The entrapped, unresponsive patient has the highest acuity and requires immediate attention. Additional resources for fire/rescue extrication should be requested. The ambulatory patient with neck pain should be stabilized and moved to a safe area. Triage principles prioritize the most critically injured first.

    Source: NREMT EMT Test Plan - Scene Size-Up and Safety / Multiple Patients

  9. Patient assessment8 of 20

    A 45-year-old man with diabetes is found unresponsive at home. Blood glucose is 42 mg/dL. His airway is patent and he is breathing. What is your INITIAL treatment?

    The answer

    Answer: C. An unresponsive patient cannot safely swallow oral glucose due to aspiration risk. The initial treatment for hypoglycemia in an unresponsive patient is to position them supine, administer oxygen, and transport for IV dextrose or glucagon. Oral glucose is contraindicated in unconscious patients.

    Source: NREMT EMT Test Plan - Patient Treatment / Oral Glucose Contraindications

  10. Patient assessment9 of 20

    During reassessment of a stable patient, you should evaluate vital signs and reassess the chief complaint at minimum every:

    The answer

    Answer: D. For stable patients, reassessment of vital signs and the chief complaint should occur at minimum every 15 minutes during transport. Unstable patients require reassessment every 5 minutes. This frequency allows early detection of changes in patient condition and ensures timely intervention if the patient deteriorates.

    Source: NREMT EMT Test Plan - Secondary Assessment / Reassessment

  11. Patient assessment10 of 20

    A 30-year-old woman presents with sudden severe headache, nausea, and nuchal rigidity. She is alert and oriented. What is the MOST appropriate transport decision?

    The answer

    Answer: C. Sudden severe headache with nuchal rigidity and nausea suggests possible subarachnoid hemorrhage or meningitis. These are life-threatening conditions requiring rapid transport to a facility with CT scanning capability. Delaying transport for a full secondary assessment would waste critical time. Every minute counts for these patients.

    Source: NREMT EMT Test Plan - Patient Treatment and Transport / Transport Priority

  12. Airway management11 of 20

    You are managing the airway of an unresponsive patient who is vomiting. After suctioning the oropharynx, what is your NEXT intervention?

    The answer

    Answer: C. After suctioning, the next step is to insert an oropharyngeal airway (OPA) to maintain airway patency, then begin BVM ventilations if the patient is apneic or breathing inadequately. The OPA is appropriate for unresponsive patients with no gag reflex. NPAs are an alternative but OPAs are preferred for oral airway management.

    Source: NREMT EMT Skill Sheet - Airway Management Sequence

  13. Airway management12 of 20

    An OPA is contraindicated in a patient who:

    The answer

    Answer: B. An oropharyngeal airway (OPA) is contraindicated in patients with an intact gag reflex because it can stimulate vomiting and aspiration. It should only be used in unresponsive patients typically with GCS 8 or below with no gag reflex. Facial trauma is a relative contraindication for NPA, not OPA.

    Source: NREMT EMT Skill Sheet - OPA Insertion Contraindications

  14. Airway management13 of 20

    You are ventilating an apneic adult patient with a BVM at 15 LPM of oxygen. What is the correct rate of ventilations?

    The answer

    Answer: C. For an apneic adult patient, BVM ventilations should be delivered at a rate of 1 breath every 5-6 seconds, which equals approximately 10-12 breaths per minute. This rate provides adequate oxygenation without causing gastric distension. The 30:2 ratio applies during CPR, not for ventilations alone.

    Source: NREMT EMT Skill Sheet - BVM Ventilation Rate per AHA BLS Guidelines

  15. Airway management14 of 20

    A patient with suspected basilar skull fracture requires airway management. Which airway adjunct should you AVOID?

    The answer

    Answer: C. A nasopharyngeal airway (NPA) is contraindicated in patients with suspected basilar skull fracture because the tube can enter the cranial cavity through the fracture. An OPA can be used if the patient has no gag reflex. The jaw-thrust maneuver is preferred for maintaining the airway in trauma patients.

    Source: NREMT EMT Skill Sheet - NPA Contraindications

  16. Airway management15 of 20

    A patient in respiratory distress has SpO2 of 88% on room air. He is alert and breathing spontaneously. What oxygen delivery device is MOST appropriate?

    The answer

    Answer: B. An SpO2 of 88% indicates significant hypoxia. A non-rebreather mask at 10-15 LPM delivers 60-90% FiO2 and is appropriate for moderate to severe hypoxia. Nasal cannula at 2 LPM only delivers 24-28% FiO2. BVM ventilations are for apneic or inadequately breathing patients, not spontaneously breathing ones.

    Source: NREMT EMT Test Plan - Patient Treatment / Oxygen Therapy

  17. Airway management16 of 20

    You arrive to find a 3-year-old who is drooling, sitting in a tripod position, and has a muffled voice. The child is febrile. What condition should you MOST suspect?

    The answer

    Answer: A. The classic presentation of epiglottitis is drooling, tripod positioning, muffled voice, and fever. This is a life-threatening emergency due to potential complete airway obstruction. Croup typically presents with a barky cough and stridor. Do NOT attempt to visualize the epiglottis or place anything in the mouth.

    Source: NREMT EMT Test Plan - Patient Treatment / Special Populations - Pediatric

  19. Airway management17 of 20

    When suctioning a patient's oropharynx, what is the MAXIMUM duration for each suction pass?

    The answer

    Answer: A. Each suction pass should last no more than 10 seconds to minimize hypoxia. Insert the suction catheter without suctioning, then apply suction only while withdrawing. Monitor the patient's SpO2 and pulse throughout the procedure. Have the BVM ready in case the patient becomes hypoxic.

    Source: NREMT EMT Skill Sheet - Suctioning Technique

  20. Airway management18 of 20

    An adult patient is apneic with a palpable carotid pulse. You should provide rescue ventilations at a rate of:

    The answer

    Answer: D. For a patient with a pulse but no breathing (respiratory arrest), provide rescue ventilations at 1 breath every 5-6 seconds, which equals 10-12 breaths per minute. The 30:2 and 15:2 ratios apply only during cardiac arrest with CPR. Check the pulse every 2 minutes to monitor for cardiac arrest.

    Source: NREMT EMT Skill Sheet - Rescue Breathing per AHA BLS Guidelines

  21. Medical emergency19 of 20

    A 68-year-old man presents with crushing chest pain, shortness of breath, and nausea. BP is 148/92, HR 92, SpO2 94%. What medication should you administer FIRST?

    The answer

    Answer: B. Aspirin should be administered BEFORE nitroglycerin for suspected cardiac chest pain. Aspirin 324 mg (four 81 mg chewable tablets) should be chewed, not swallowed whole. Aspirin inhibits platelet aggregation and may limit clot formation. Nitroglycerin is given after aspirin if blood pressure permits.

    Source: NREMT EMT Test Plan - Patient Treatment / Medication Administration - Aspirin

  22. Medical emergency20 of 20

    A patient with chest pain has a systolic blood pressure of 82 mmHg. He reports taking sildenafil 12 hours ago. Which medication is CONTRAINDICATED?

    The answer

    Answer: B. Nitroglycerin is contraindicated when systolic BP is below 90 mmHg and when the patient has taken a phosphodiesterase-5 inhibitor (sildenafil within 24 hours, tadalafil within 48 hours). The combination can cause severe, potentially fatal hypotension. Aspirin and oxygen are still appropriate treatments.

    Source: NREMT EMT Test Plan - Patient Treatment / Nitroglycerin Contraindications

Official Test Specs & Sourced Summary

The official NREMT EMT knowledge examination covers Computerized adaptive test with a passing threshold of 75%. Questions written from the NREMT EMT Candidate Handbook and the National EMS Education Standards; not official NREMT items. Every question on this page is original, with an explanation and a note citing its source.

Passing Score75% target
FormatComputerized adaptive test · item count and difficulty vary by candidate
Question Bank300 questions (20 free)
Verified SourceNREMT EMT Candidate Information Bulletin & National EMS Education Standards

That’s the free set. The full bank has 300.

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